Skip to main content

This Week in the GeriPal Blogosphere


Every time I get off the phone with Christian Sinclair (AAHPM board member, Pallimed rock-star, and social media guru) I become very excited about the wonderful community of bloggers we have online. So in today's post I just want to highlight four outstanding posts that have popped up online in the last week.

1.  This week's best post on grammar: Care Coordination Is Not a Noun

Chris Langston from the health AGEnda (the John A. Hartford Foundation blog) argues that far to often "we act as if care coordination was a thing that might come in a box, brought to us by a care coordinator." This post is well worth reading for the examples used to describe his conclusion, which is elequently stated as "care coordination is a system property that requires careful redesign of plans and procedures, new hardware and new software, and yes, new people in new positions, but none of these features taken alone defines care coordination."

2.  This week's best post on the intersection between geriatrics and palliative careCartography of EOL Pain

Brian McMichael from Pallimed reviews an article that GeriPal's very own Alex Smith was the lead author on - "The epidemiology of pain during the last 2 years of life". Brian breaks down the article in the first half of his post and comes away with some take away points that I feel highlight the need for more geriatric content within palliative care:
"I have felt like arthritis is this incidental given, dwarfed by the likes of angina, dyspnea, acute fracture, and malignant pain, etc.; a kind of tell-me-something-I-don’t-already-know entity. It’s surprising to see this common, benign condition produce such a large overall, and then burgeoning burden of pain at end-of-life."

3.  This week's best post on Community - Palliative Care Grand Rounds

Compassion & Choices is hosting this month’s Palliative Care Grand Rounds. If you are not sure what grand rounds is check it out for a flavor of some online offerings. 

4.  This weeks best post on why we need to be online - Why Doctors Should Care About Social Media

Bryan Vartabedian from 33 Charts lists 6 reasons why doctors (I'll expand this to all health care professionals) should be using social media. The most salient reason for both geriatrics and palliative care is the last - the world needs to see us as part of the global dialog. He ends (as do I) with the following:
"If each of us shared even small, regular contributions (doctor-doctor, doctor-patient, doctor-policy maker) the impact would be dramatic."
by: Eric Widera

Comments

Anonymous said…
Thank you Eric, Alex and all GeriPal contributors for all that you do to highlight the importance of palliative care for older adults.

Popular posts from this blog

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …

Dying without Dialysis

There is a terrific article in this weeks Journal of Pain and Symptom Management by Fliss Murtagh of King's College in London about the epidemiology of symptoms for patients with advanced renal failure who die without dialysis.  This study is important because while we know that patients with advanced renal failure have a limited life expectancy and the average age of initiation of hemodialysis is increasing, we know little about the alternatives to hemodialysis.  Specifically, we know nothing about symptoms affecting quality of life among patients who elect not to start dialysis (so called "conservative management" - is this the best label?).  This article provides a terrific counterpoint to the article in last years NEJM showing that nursing home residents who initiated hemodialysis tended to die and decline in function (see GeriPal write up here). 

The study authors followed patients with the most advanced form of chronic kidney disease (the new name for renal failu…

Survival from severe sepsis: The infection is cured but all is not well

Severe sepsis is a syndrome marked by a severe infection that results in the failure of at least one major organ system: For example, pneumonia complicated by kidney failure. It is the most common non-cardiac cause of critical illness and is associated with a high mortality rate.

But what happens to those who survive their hospitalization for severe sepsis? An important study published in JAMA from Iwashyna and colleagues provides answers and tells us all is not well. When the patient leaves the hospital, the infection may be cured, but the patient and family will need to contend with a host of major new functional and cognitive deficits.

Iwashyna examined disability and cognitive outcomes among 516 survivors of severe sepsis. These subjects were Medicare enrollees who were participants in the Health and Retirement Study. The average age of patients was 77 years.

When interviewed after discharge, most survivors were left with major new deficits in their ability to live independently. …